title: Uterine leiomyoma associated non-puerperal uterine inversion misdiagnosed as advanced cervical cancer: A case report.
abstract: BACKGROUND
  Uterine inversion is an un-common complication of parturition which often occurs in the immediate postpartum period. The chronic (non-puerperal) uterine inversion is rarer and most times tumour associated.
  
  
  METHODS
  A 51-year old grand multiparous lady presented with a month history of abnormal vaginal bleeding associated with offensive vaginal discharge, lower abdominal pain and dizziness. The initial evaluation suggested severe anaemia secondary to advanced cervical cancer. Examination under anaesthesia (EUA), staging and biopsy was attempted but this was however inconclusive due to profuse haemorrhage. A repeat EUA revealed chronic uterine inversion secondary to fundal submucous uterine leiomyoma. Myomectomy was done with tissue histology confirming benign uterine leiomyoma. Two weeks later, a modified Haultain's procedure was done followed by simple hysterectomy and posterior colpoperineorrhaphy. She had satisfactory recovery.
  
  
  CONCLUSIONS
  This is the first reported case of chronic non-puerperal uterine inversion in our hospital. When it occurs, it is usually tumour associated with the commonest tumour being prolapsed myoma and leiomyosarcoma. The diagnosis is based on high index of suspicion.
  
  
  CONCLUSIONS
  Chronic uterine inversion is a rare gynaecological condition and can be misdiagnosed as advanced cervical cancer or other causes of severe genital haemorrhage in women. A high index of suspicion is needed for its proper diagnosis. Sometimes, an EUA and biopsy was required to determine the cause here and conveniently it could be described as a "gynaecolological near miss".
authors.affiliation: Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria. Electronic address: docomene@gmail.com.
authors.forename: Osita Samuel
authors.initials: OS
authors.lastname: Umeononihu
authors.forename: Joseph Ifeanyi
authors.initials: JI
authors.lastname: Adinma
authors.forename: Nworah J
authors.initials: NJ
authors.lastname: Obiechina
authors.forename: George Uchenna
authors.initials: GU
authors.lastname: Eleje
authors.forename: Onyebuchi Izuchukwu
authors.initials: OI
authors.lastname: Udegbunam
authors.forename: Ikechukwu Innocent
authors.initials: II
authors.lastname: Mbachu
keywords: Chronic uterine inversion; Gynaecological near miss; Misdiagnosed; Non-puerperal; Tumour